FAO Calls for More Efforts to Combat Avian Flu as Cases Rise Worldwide
Outbreaks 01/08/2024 •
Exposure to infected poultry is among the main sources of avian flu infections

As more avian flu cases are detected across the Asia-Pacific region, the Food and Agriculture Organization (FAO) is calling for “regional efforts to combat a rise” of the disease. Over the past year, highly pathogenic avian influenza clades, especially H5N1, have gained ground globally, infecting an increasing number of species, including poultry, dairy cows, and domestic animals.

As of July 31, one single avian flu variant of H5N1 had infected 172 dairy herds and 13 farm workers in the United States  and continues to spread further, raising questions about the country’s ability to curb the transmissions. 

In the Asia-Pacific region, there have been 13 human H5N1 avian flu cases since late 2023, six of which were reported in Cambodia this year. The newly-reported cases point to a trend of more human infections from the virus.  And in the Asian-Pacific, at least one other avian flu variant is circulating along with the H5N1 type, clade 2.3.4.4b, prevalent in the US.  

“All these cases involved direct contact with poultry or wild birds, and so far, no human-to-human transmission has been observed,” confirmed Filip Claes, FAO’s Asia-Pacific Regional Laboratory Coordinator in an email response to Health Policy Watch.

“The primary threat is that HPAI continues to circulate in poultry causing economic losses. Additionally, it provides an opportunity [for the virus] to continuously adapt, and spill over to additional species, including humans,” he added.

He called for building diagnostics capacity and more data sharing, along with strengthening farming biosecurity and biosafety measures.

Avian influenza has even reached the arctic and Antarctic regions, infecting scavenger species, marine mammals, carnivorous domestic pets, and mammals farmed for fur, and dairy cattle. Since last year, there have been human cases in Australia, India, the US, Mexico, Vietnam, China, and Cambodia. 

Of the 886 human infections reported from 2003 to May 2024, more than half were fatal.

Alhough the World Health Organization continues to assess H5N1-related risks to the public as low (and low-to-moderate for farm workers), the emergence of new, more easily transmissible strains “increases the pandemic threat,” warned Kachen Wongsathapornchai, Regional Manager of FAO Emergency Centre for Transboundary Animal Diseases earlier this week. Calling the recent bird flu surge “deeply concerning” the FAO official appealed for “immediate action.”

Insufficient outbreak response

Avian flu H5N1 situation update as of 31 July 2024 – all reports since outbreak began in March.

“Strengthening and integrating surveillance systems is crucial,” Claes said, enumerating measures South-East Asian countries should implement to fight the outbreaks. “Countries should invest in advanced diagnostic infrastructure and training for laboratory personnel,” as well as enhance international and inter-agency collaboration, prepare biosecurity protocols for farms and consider vaccination campaigns.

In the US, where the virus has infected an expanding circle of dairy cattle herds since first reports emerged in March, the country response is insufficient, US experts have long maintained.

There is, for instance, too little data and research that would ensure better understanding of the virus and the ways in which it transmits – not only through the mammary glands during milking, as was previously thought, new research seems to suggest.

Farmers reluctant to have herds and workers tested

Modes of infection with avian flu from poultry – a likely transmission path for some of the human cases

There is not enough testing infrastructure either. And farmers and their employees are reluctant to get themselves or their cattle tested, posing yet another problem in the US where there is no legal framework for mandatory animal tests.  

Similarly, for farm workers, testing and even wearing personal protective equipment is neither compulsory nor popular due to a general mistrust towards the official agencies, fear of lost revenue or, in the case of the workers, lack of a healthcare insurance.

Meanwhile, lax sanitation procedures in large dairy operations are big enablers of virus transmission, allowing cow-to-cow transmission when milking machines are not cleaned between every individual animal.

“Much more extensive follow up, serology studies and close monitoring of ‘mixing vessel animal species’, for instance pigs,” which can more easily incubate and transmit viruses to humans is needed, said Michael Osterholm, director of the University of Minnesota-based Centre for Infectious Disease Research and Policy (CIDRAP), in earlier comments to Health Policy Watch.

Overall, a more coherent plan of response is urgently needed in the Americas as well as Asia, Claes emphasized. In creating a plan, communication about the risk “with all stakeholders, from national governments to grassroots levels, is crucial to develop awareness and community engagement in tackling and controlling avian influenza.” 

Image Credits: Pickpik, USDA, CDC.

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